Modern endoscopic methods for the diagnosis of laterally spreading tumors (LST) of the colon

The aim: to focus on the possibilities of modern endoscopy in the diagnosis of laterally spreading (creeping) tumors — LST (laterally spreading tumor) of the colon.Materials and methods: description and comparison, based on data available in the literature, of modern endoscopic techniques for the diagnosis and differential diagnosis of LST.Results: the analysis and systematization of the obtained data revealed the advantages of modern endoscopic diagnostic methods not only in detecting LST, but also in predicting their morphological structure.Conclusion: the use of modern endoscopic diagnostic methods allows not only to improve the detection of neoplasms, but also to choose the best options for further treatment based on the information received.

Fecal Enterotoxigenic Bacteroides fragilis–Peptostreptococcus stomatis–Parvimonas micra Biomarker for Noninvasive Diagnosis and Prognosis of Colorectal Laterally Spreading Tumor

ObjectiveUp to now, non-invasive diagnosis of laterally spreading tumor (LST) and prediction of adenoma recurrence after endoscopic resection of LSTs is inevitable. This study aimed to identify a microbial signature with clinical significance of diagnosing LSTs and predicting adenoma recurrence after LSTs colectomy.MethodsWe performed 16S rRNA sequencing in 24 mucosal samples, including 5 healthy controls (HC), 8 colorectal adenoma (CRA) patients, and 11 LST patients. The differentiating microbiota in fecal samples was quantified by qPCR in 475 cases with 113 HC, 208 CRA patients, 109 LST patients, and 45 colorectal cancer (CRC) patients. We identified differentially abundant taxa among cases and controls using linear discriminant analysis effect size analysis. ROC curve was used to evaluate diagnostic values of the bacterial candidates. Pairwise comparison of AUCs was performed by using the Delong’s test. The Mantel-Haenszel hazard models were performed to determine the effects of microbial compositions on recurrence free survival.ResultsThe microbial dysbiosis of LST was characterized by relative high abundance of the genus Lactobacillus-Streptococcus and the species enterotoxigenic Bacteroides fragilis (ETBF)–Peptostreptococcus stomatis (P. stomatis)–Parvimonas micra (P. micra). The abundance of ETBF, P. stomatis, and P. micra were steadily increasing in LST and CRC groups. P. stomatis behaved stronger value on diagnosing LST than the other two bacteria (AUC 0.887, 95% CI 0.842–0.931). The combination of P. stomatis, P. micra, and ETBF (AUC 0.922, 95% CI 0.887–0.958) revealed strongest diagnostic power with 88.7% sensitivity and 81.4% specificity. ETBF, P. stomatis, and P. micra were associated with malignant LST (PP.stomatis = 0.0015, PP.micra = 0.0255, PETBF = 0.0169) and the abundance of IL-6. The high abundance of P. stomatis was related to the adenoma recurrence after LST resection (HR = 3.88, P = 0.008).ConclusionsFecal microbiome signature (ETBF–P. stomatis–P. micra) can diagnose LSTs with high accuracy. ETBF, P. stomatis, and P. micra were related to malignant LST and P. stomatis exhibited high predictive value on the adenoma recurrence after resection of LSTs. The fecal microbiome signature of LST may provide a noninvasive alternative to early detect LST and predict the adenoma recurrence risk after resections of LSTs.